剖宮產(chǎn)術(shù)后硬膜外自控鎮(zhèn)痛對(duì)泌乳及相關(guān)因素的影響.pdf

1、Objective: To observe the influence of PCEA on lactation and the correlatedfactors after cesarean section.Methods: Thirty full-term parturients who have no other complications such asdiabetes , cardiopathy, thyroid gland

2、 disease ,undergoing elective cesarean sectionunder epidural anaesthesia randomly divided into two groups: the PCEAgroup(n=15)and the controlled group(n=15).All the women were volunteered .All thewomen were choosed epid

3、ural anaesthesia 1.5％ lidocaine. The dose of lidocaine andthe operation time were no significant difference. The PCEA group: epiduralanesthesia followed by postoperative patient-controlled analgesia(PCEA)withepidura

4、l morphine, fentanyl and bupivacain. We set the basal injection rate was 2ml /h, the locked time was 30minutes and the controlled injection dose was 5ml each time.The controlled group wasn't injected any analgesia agent.

5、 Assessed the degree of thepain by using visual analog scale(VAS).Detect the prolactin(PRL) and thyroidstimulating hormone(TSH) level in plasma before operation, after operation 24h,48hseparately by electrochemiluminesce

6、nce immunoassay(ECLI). And compare thedifference of the two groups. Keep note of the first time that puerperal women hadmilk and the times that breastfeeding their infants everyday and whether supplied thesupplements of

7、milk or not. All the data were analyzed statistically.Results :The VAS scores of the PCEA group were lower than that of thecontrolled group(p＜0.01). The first lactation time of the PCEA group wasdistinctively earlier tha

8、n that of the controlled group (p＜0.01). Breastfeeding theirinfants more than 8 times every 24 hour, the PCEA group was significantly more thanthe controlled group(p＜0.01). The amount of the milk during 72 hours, the PCE

9、Agroup was higher than the controlled group(p＜0.01). The postoperative level ofPRL 、 TSH in plasma of PCEA group were all higher than that of beforeoperation(p＜0.05). The postoperative 24h、 48h PRL、 TSH concentration i

10、n plasmaof the PCEA group were higher than the controlled group(p＜0.05). .Nursing timesof the PCEA group were distinctive higher than the controlled group.Conclusion:The PCEA has a very good effect on puerperal women a